Harry and Louise, the ad couple who helped derail Bill Clinton's push for health-care reform in the early '90s, are back, and this time they're playing for the other team. They're perhaps symbolic of the mid-summer muddle in which a number of players who were openly hostile to the Clinton push are claiming to be for reform -- of some sort.

And though some observers doubt that the fictitious duo will be nearly as effective this time around, their re-entry has left patient-advocate groups and private insurance companies scrambling to counteract the message as President Barack Obama is pressing legislators to agree on the estimated $1 trillion health-care reform before Congress recesses next month.

Harry and Louise entered advertising lore in the early 1990s as the married couple who opposed President Bill Clinton's health-care reform package -- and ultimately proved to be one of the catalysts that doomed the plan. Now they're supporting Mr. Obama's health-care initiative -- as vague as that may be at the moment -- as part of a three-week, $4 million "Harry and Louise" campaign running on cable and broadcast networks. The effort is being co-sponsored by the consumer health-care advocacy group Families USA and the Pharmaceutical Research and Manufacturers of America (PhRMA), the pharma industry's chief lobby group. Both are based in Washington.

Ironically, the two groups have long been adversaries when it comes to health care, but PhRMA President-CEO Billy Tauzin said it's time to recognize the common goal of reform.

"This is a historic opportunity for change," Mr. Tauzin said in a statement, "and working together we can achieve our goal, which will benefit both patients and the U.S. economy."

The quandary remains, however, the philosophical difference between those who believe the government should run health care, and those who believe the system should be fixed so that those without access to care have it whether they can pay for it or not.